HomeMy WebLinkAboutR2020-0917 - Permit ApplicationCITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949)644-3200
RBR # R202o ` 0911
Application for Report of Residential Building Records
Application Fee: $191.00 Notice:
(For All Residential Buildings) Application with insufficient fee payment
Reinspection Fee $125.00 or incomplete will be returned
Please type or print and complete all information
Number of units: Street Address: 338 Holmwood Drive
Property Owner: NSC Enterprises Inc. Zip Code:
Owner Address:
Street
Home Phone:
City
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Zip COAy441JfV17,
Work Phone: nil 2
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Owner's Authorized Agent: STEPHANIE PETERSOCASEY O'CONNOR, ARBOR REAL ESTATE
Agent Address: 425 30TH STREET # 1 , Newport Beach, CA 92663 1�- OEVCIOPrygENT
Work Phone: 949 673-7600 ok4'FWPORT 6�PO�
Escrow Name and Address: West Coast Escrow, Escrow No. 4530620-10235 - SEH
Escrow Address: 840 Newport Center Drive, Suite 150, Newport Beach 92660 Escrow Phone: (949) 759-7072
Email Report to: sandi.heben(c-)westcoastescrow.com
For Inspection Call (Name): DECLINE INSPECTION
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW)
I authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning violations
are discovered I will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection Date
�OR
Owner/Agent's signature to decline inspections Date I te 6,�.3- b
Account #01050504-521040............ Make checks payable to CITY OF NEWPORT BEACH
Who to call for inspection?
Name: Direct Phone: